Difficulty Eating Research Articles

Comparison of safety insertion techniques of percutaneous endoscopic gastrostomy in nurses and physicians - a non-randomized interventional pilot study on a simulation model

Percutaneous endoscopic gastrostomy (PEG) insertion represents a standardized procedure for enteral nutrition in patients with long-term eating difficulties for various reasons. In a clinical setting, delegation of stomach puncture and placement of a PEG tube, within the context of percutaneous endoscopic gastrostomy amongst nurses, occurs. In Germany, there are no studies yet showing the differences between physicians and nurses regarding the safety of percutaneous stomach puncture.In a non-randomized quasi-experimental interventional study on a simulation model, the safety of stomach puncture within the context of percutaneous endoscopic gastrostomy between physicians and nurses with special training was compared. Technical skills were recorded with video cameras and provided the basis for the following analysis. The study contained: (1) a theoretical preparation phase, (2) training on simulation model and a repeated practice of the skills, and (3) stomach puncture on the simulation model. The actions were recorded with a multichannel video technique. As part of the concept, nurses and physicians were trained together in theory and practice. The analysis was conducted with the newly designed Assessment Instrument Percutaneous Endoscopic Gastrostomy (AS-PEG). Seven physicians and 17 nurses took part in the pilot study. On average, the physicians reached a score of 36.4 ± 2.2 (33 - 39) and nurses 37.4 ± 2 (32 - 40), while the maximum score was 42. The evaluation of technical skills on the recorded videos by means of Assessment Instrument Percutaneous Endoscopic Gastrostomy (AS-PEG) showed no tendency to significant differences between physicians and nurses after theoretical and practical training. The study contributes a first objective evaluation of technical skills on stomach puncture within the context of percutaneous endoscopic gastrostomy with the newly designed AS-PEG.

Parent-reported indicators for detecting feeding and swallowing difficulties and undernutrition in preschool-aged children with cerebral palsy.

To determine the most accurate parent-reported indicators for detecting (1) feeding/swallowing difficulties and (2) undernutrition in preschool-aged children with cerebral palsy (CP). This was a longitudinal, population-based study, involving 179 children with CP, aged 18 to 60 months (mean 34.1mo [SD 11.9] at entry, 111 males, 68 females [Gross Motor Function Classification System level I, 84; II, 23; III, 28; IV, 18; V, 26], 423 data points). Feeding/swallowing difficulties were determined by the Dysphagia Disorders Survey and 16 signs suggestive of pharyngeal phase impairment. Undernutrition was indicated by height-weight and skinfold composite z-scores less than -2. Primary parent-reported indicators included mealtime duration, mealtime stress, concern about growth, and respiratory problems. Other indicators were derived from a parent feeding questionnaire, including 'significant difficulty eating and drinking'. Data were analysed using multilevel mixed-effects regression and diagnostic statistics. Primary parent-reported indicators associated with feeding/swallowing were 'moderate-severe parent stress' (odds ratio [OR]=3.2 [95% confidence interval {CI} 1.3-7.8]; p<0.01), 'moderate-severe concern regarding growth' (OR=4.5 [95% CI 1.7-11.9]; p<0.01), and 'any respiratory condition' (OR=1.8 [95% CI 1.4-5.8]; p<0.01). The indicator associated with undernutrition was 'moderate-severe concern regarding growth' (height-weight OR=13.5 [95% CI 3.0-61.3]; p<0.01; skinfold OR=19.1 [95% CI 3.7-98.9]; p<0.01). 'Significant difficulty eating and drinking' was most sensitive/specific for feeding outcome (sensitivity=58.6%, specificity=100.0%), and 'parent concern regarding growth' for undernutrition (sensitivity=77.8%, specificity=77.0%). Parent-reported indicators are feasible for detecting feeding and swallowing difficulties and undernutrition in children with CP, but need formal validation. Parent-reported indicators can detect feeding/swallowing difficulties and undernutrition in children with cerebral palsy. Most accurate screening questions were 0-10 scales for 'difficulty eating' and 'difficulty drinking'. Supplementation of these scales with additional indicators would improve detection.

Brain Injury and Severe Eating Difficulties at Admission-Patient Perspective Nine to Fifteen Months after Discharge: A Pilot Study.

The purpose of this pilot study was to explore and interpret the way that individuals with acquired brain injury, admitted to inpatient neurorehabilitation with severe eating difficulties, experienced eating nine to fifteen months after discharge. Four individuals with acquired brain injury were interviewed via qualitative semi-structured interviews. An explorative study was conducted to study eating difficulties. Qualitative content analysis was used. Four main themes emerged from the analysis: personal values related to eating, swallowing difficulties, eating and drinking, meals and social life. Three predominating experiences were: fed by tube, “relearning” to eat, and eating meals together. The preliminary results regarding the four participants suggest that the meaning of food and being able to eat and take part in meals may be nearly the same as before the injury; however, having the ability to eat reduced or lost completely, even temporarily, was unexpected and difficult, and caused strong emotional reactions, even 18 months after injury. Time spent using a feeding tube had a negative, but not persistent, impact on quality-of-life. The preliminary findings provide knowledge regarding the patient perspective of adapting to and developing new strategies for activities related to eating, however, further prospective, longitudinal research in a larger scale and with repeated interviews is needed.

Predictors of weight loss in early treated Parkinson's disease from the NET-PD LS-1 cohort.

Weight loss is a common symptom of Parkinson's disease and is associated with impaired quality of life. Predictors of weight loss have not been studied in large clinical cohorts. We previously observed an association between change in body mass index and change in Unified Parkinson's Disease Rating Scale (UPDRS) motor and total scores. In this study, we performed a secondary analysis of longitudinal data (1-6 years) from 1619 participants in the NINDS Exploratory Trials in PD Long-term Study-1 (NET-PD LS1) to explore predictors of weight loss in a large prospective clinical trial cohort of early treated Parkinson's disease. The NET-PD LS1 study was a double-blind randomized placebo controlled clinical trial of creatine monohydrate 10 gm/day in early treated PD (within 5 years of diagnosis and within 2 years of starting dopaminergic medications). Linear mixed models were used to estimate the effect of baseline clinical covariates on weight change over time. On average, participants lost only 0.6 kg per year. Higher age, baseline weight, female gender, higher baseline UPDRS scores, greater postural instability, difficulty eating and drinking, lower cognitive scores and baseline levodopa use (compared to dopamine agonists) were all associated with weight loss. Surprisingly baseline difficulty swallowing, dyskinesia, depression, intestinal hypomotility (constipation) and self-reported nausea/vomiting/anorexia were not significantly associated with weight loss in this cohort of early treated Parkinson's disease patients. On average, participants with Parkinson's disease experience little weight loss during the first 1-6 years after starting dopaminergic replacement therapy, however levodopa use and postural instability were both predictors of early weight loss. Trial Registration clinicaltrials.gov identifier# NCT00449865.

Can Preoperative Intramuscular Single-Dose Dexamethasone Improve Patient-Centered Outcomes Following Third Molar Surgery?

Because of increased attention focused on administering dexamethasone to treat third molar surgical complications, this study investigated the efficacy of single-dose dexamethasone in managing postoperative complications after impacted third molar surgery. Pain intensity and analgesic intake, patients' discomfort, limitation of oral function, and limitation of daily activities were assessed. This triple-blinded split-mouth randomized controlled clinical trial included patients 18 to 30years old who underwent randomized bilateral extractions of impacted mandibular third molars during 2 consecutive sessions. Each patient was given a single-dose intramuscular injection of dexamethasone (0.1mg/kg) preoperatively in 1 session and a placebo in the other session. Data were collected daily for 7 postoperative days, and 14 patient-centered outcomes were interpreted. A 2-tailed P value less than .05 was considered significant. All 32 patients (100%) enrolled completed the study. When administered dexamethasone, patients reported less pain (P≤.007), took fewer analgesics (P≤.002), reported less swelling (P≤.007), had less difficulty in eating (P≤.024), had less difficulty in enjoying food (P≤.005), had less difficulty in speech (P=.043), had less trismus (P=.005), were absent less from school or work (P≤.016), and had less disruption of daily activity (P≤.042). The differences between the 2 conditions in bleeding, malaise, and sleep disturbance were not significant (P>.05). Prophylactic dexamethasone administered intramuscularly before third molar surgery should be recommended as a safe and effective strategy for decreasing pain and discomfort and enhancing oral functions and daily activities, unless contraindicated.

Associations between food consumption patterns and saliva composition: Specificities of eating difficulties children

Identifying objective markers of diet would be beneficial to research fields such as nutritional epidemiology. As a preliminary study on the validity of using saliva for this purpose, and in order to explore the relationship between saliva and diet, we focused on clearly contrasted groups of children: children with eating difficulties (ED) receiving at least 50% of their energy intake through artificial nutrition vs healthy controls (C). Saliva of ED and C children was analyzed by various methods (targeted biochemical analyses, 2-D electrophoresis coupled to MS, 1H NMR) and their diet was characterized using food frequency questionnaires, considering 148 food items grouped into 13 categories. Complete datasets were obtained for 16 ED and 16 C subjects (median age 4.7y and 5.0y, respectively) and the statistical link between salivary and dietary characteristics was studied by Multiple Factor Analysis (MFA).Overall, ED children showed as expected lower consumption frequency scores and higher food selectivity. The two groups of children differed in “diet/saliva” associations. Some distinctive salivary variables were common to both groups of children. For example, carbonic anhydrase 6 and the consumption frequency of biscuits & sweets and drinks were positively associated with the MFA axis 1 in C children, but oppositely associated in ED children. Specifically for ED children, abundant salivary proteins (cystatins, amylase, amylase fragments) and some metabolites (amino acids, galactose, lactate) correlated with axis 1, together with the consumption frequency of sauces & seasonings, bread & cereal products, ready-to-eat meals, fish, biscuits & sweets, drinks and potatoes. Specifically for C children, several proteins (serum albumin, haptoglobin, Igκ, apolipoprotein A-1, α-1 antitrypsin) correlated with axis 1, together with the consumption frequency of biscuits & sweets, milk & dairy products, drinks, fruit, meat and vegetables.This study demonstrates that the qualitative aspect of diet is linked to saliva composition, and that the associations between dietary consumption and salivary composition differ between groups of subjects with contrasted diets.

PP - PERIPHERAL OSSIFYING FIBROMA IN GINGIVA: A CASE REPORT OF AN UNUSUALLY LARGE LESION

Peripheral ossifying fibroma is a gingival overgrowth that is considered a reactive lesion of unknown pathogenesis. It usually originates from the interdental papillae, presenting as a sessile or pedunculated nodular mass, pink to red in color, and frequently ulcerated surface. Occasionally, it can reach large size. Aim: To report a case of an unusually large peripheral ossifying fibroma. Case report: A 45-year-old male came to the stomatology clinic, complaining of limited mouth opening and difficulty in eating. Extraoral exam revealed facial asymmetry and trismus, and intraoral exam showed a red, multilobular, sessile mass, approximately 7.0 cm in size, extending from the upper right pre-molar to the upper left lateral incisor and causing teeth dislocation. Panoramic radiography revealed radiopacity in the lesion area and interdental bone destruction. The clinical diagnostic hypothesis was peripheral ossifying fibroma. An excisional biopsy was performed, and histopathologic analysis confirmed the diagnosis. Conclusion: Although peripheral ossifying fibroma is relatively common, the size of the lesion in this patient is uncommon, leading to a concern with respect to the esthetic and functional factors.

Oral Health Status and Impact on Oral Health-Related Quality of Life in Children with Thalassemia Major

&lt;p class="AbstractContent"&gt;&lt;strong&gt;Objective:&lt;/strong&gt; The purpose of this study was to assess oral health status in children with thalassemia major, and the association of oral health status with oral-health related to quality of life.&lt;/p&gt;&lt;p class="AbstractContent"&gt;&lt;strong&gt;Methods&lt;/strong&gt;: This cross-sectional study was comprised of 81 patients from various parts of lower northern Thailand. The study consisted of an interview and intraoral examination on thalassemia children at the hospital while they were undergoing routine blood transfusions. Data regarding OHI-S, DMFT/dmft and child-OIDP were determined for all the subjects.&lt;/p&gt;&lt;p class="AbstractContent"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The prevalence of oral impacts was high; 82.8% of all children reported at least one oral impact affecting their daily performance according to the Child-OIDP. The most prevalent impact was difficulty in eating.&lt;/p&gt;&lt;p class="AbstractContent"&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: The risks of oral disease in thalassemia children remain high which affect their quality of life.&lt;/p&gt;

The relation of preoperative stress and anxiety on patients' satisfaction after implant placement.

Background:There are some factors which can affect preoperative patient anxiety such as the necessity of procedure, postoperative pain, and patient's conception of his body image. The aim of this study was to assess the relation of patients' preoperative anxiety and postoperative patients' satisfaction in dental implant surgery.Materials and Methods:Dental implants were placed in 40 patients (19 male and 21 female) who were referred to Dental Implant Surgery Department in Imam Reza clinic, during March–December of 2014 in Shiraz. The procedures were performed with or without bone regeneration. Preoperative anxiety was evaluated using Corah Dental Anxiety Scale, and postoperative satisfaction was determined on the basis of pain intensity, bleeding tendency, inability to eating, and overall satisfaction by filling a questionnaire in the 2nd or 3rd week after surgery. Data were collected and analyzed using Mann-Whitney test.Results:Preoperative anxiety was detected as high in 10%, mild in 85%, and moderate in 5% of patients. Anxiety and depression score did not differ in both genders. There was no statistical difference between neither level of anxiety nor depression in both high and low educated patients. Postoperative bleeding, difficulty in eating, and overall satisfaction was nearly the same in both genders. Statistical analysis demonstrated a lower pain level and higher pain threshold in men than women (P = 0.007). Patients' age was not related to anxiety, depression, amount of bleeding, pain, and difficulty in eating. Overall dental care satisfaction was similar in both men and women.Conclusion:The results of the study indicated that while anxiety does play a role in the perception of pain by patients undergoing implant surgery, overall patient satisfaction and post surgical outcomes did not significantly differ.

Oral health-related quality of life and early childhood caries among preschool children in Trinidad.

BackgroundEarly childhood caries (ECC) is a public health problem in developed and developing countries. The purpose of this study was to describe the relationship between oral health-related quality of life (OHRQoL) and ECC among preschool children in a Caribbean population.MethodParents/primary caregivers of children attending nine, randomly selected preschools in central Trinidad were invited to complete an oral health questionnaire and have their child undertake an oral examination. The questionnaire included the Early Childhood Oral Health Impact Scale (ECOHIS). Visible caries experience was assessed using WHO criteria. Logistic regression models were used to determine the factors associated with OHRQoL and ECC.ResultsThree hundred nine parents/caregivers participated in the study (age-range 25–44 years) and 251 children (mean age 3.7 years) completed oral examinations. Adjusting for other factors, the odds for a child aged 4 years of having dental caries were greater than the odds for a child aged 3 years (OR 3.61; 95% CI (1.76, 6.83). The odds for children having difficulty drinking hot or cold drinks were greater for those with dental caries than the odds for children who have no such difficulty. Similarly, the odds for children who had difficulty eating were greater for those with dental caries than the odds ratios for children who had no difficulty eating (OR 8.29; 95% CI (2.00, 43.49). Adjusting for the effects of other factors, the odds of parents/caregivers feeling guilty were greater if their child had experienced dental caries in comparison to parents/caregivers whose child did not have dental caries (OR 3.50; 95% CI (1.32, 9.60). Adjusting for other factors, the odds of parents/primary caregivers having poor quality of life was increased when they had a child with a dmft in the range 1–3 (OR 2.68; 95% CI (1.30, 5.64) dmft > 4 (OR 8.58; 95%CI (3.71, 22.45), in comparison to those whose child had a dmft = 0.ConclusionIn this sample of preschool children OHRQoL was associated with ECC. More negative impacts were found in children with a greater severity of visible caries experience. This suggests the need for strategies to prevent and manage ECC in this Caribbean population.

An Investigation into the Relationship between Owner Knowledge, Diet, and Dental Disease in Guinea Pigs (Cavia porcellus).

Simple SummaryDental disease is a serious problem in small mammals, with cases in rabbits well documented. Guinea pigs also suffer from this condition, yet the literature investigating the underlying causes in guinea pigs is limited. Owners of guinea pigs were surveyed to investigate what they fed their animals. It was discovered that there was no relationship between the overall diet of the animals and whether or not they had been diagnosed with dental disease or displayed clinical signs of the disease. However, the environment was important, with animals that had access to the outside, including the use of runs on both concrete and grass, less likely to display clinical signs of disease. Some of the clinical signs of dental disease in guinea pigs, including difficulty eating, were related to dental problems. These findings are important, as many guinea pigs may not have continuous access to the outdoors. Dental disease is a serious welfare concern, as many owners may not pick up on the clinical signs, leaving animals susceptible to pain, dysphagia, malnutrition, and secondary infection. It is important that owners are aware of key clinical signs, particularly in multi-animal households where monitoring food consumption may be challenging.Recent studies have highlighted a high prevalence of dental disease in domestic guinea pigs, yet the aetiology of this multi-factorial disease is still unclear. Factors that have been associated with dental disease include feeding a diet that is high in energy but low in fibre, feeding an insufficiently abrasive diet, a lack of dietary calcium, and genetics. As many of these factors relate to the husbandry requirements of guinea pigs, owner awareness of dietary requirements is of the utmost importance. An online questionnaire was created based on previous research into the husbandry and feeding of rabbits. Guinea pig owners were asked to answer questions on the clinical history of their animals and their diet and management. In total, 150 surveys were completed for 344 guinea pigs, where owners of multiple animals could complete the survey for individuals. According to the owners, 6.7% of guinea pigs had been clinically diagnosed with dental disease, but 16.6% had signs consistent with dental disease. The specific clinical signs of having difficulty eating (Exp(B) = 33.927, Nagelkerke R2 = 0.301, p < 0.05) and producing fewer or smaller faecal droppings (Exp(B) = 13.733, Nagelkerke R2 = 0.149, p < 0.05) were predictive for the presence of dental disease. Having access to an outside environment, including the use of runs on both concrete and grass, was significantly related to not displaying clinical signs of dental disease (Exp(B) = 1.894, Nagelkerke R2 = 0.021, p < 0.05). There was no significant relationship between owner knowledge, guinea pig diet, and dental disease in the study population. This study highlights the importance of access to the outdoors for the health and welfare of guinea pigs in addition to the need for owners to be alert to key clinical signs. A relationship between diet and dental disease was not identified in this study; however, the underlying aetiological causes of this condition require further investigation.

The impact of oral conditions on children in England, Wales and Northern Ireland 2013

Background The 2013 Children's Dental Health survey is the fifth in a series of national surveys.Aim To summarise key findings on oral health perceptions, oral symptoms, and the impacts of oral conditions on the daily life of children and their families.Methodology A representative sample of children (aged 5, 8 12 and 15 years) and their parents in England, Wales and Northern Ireland completed relevant questionnaires.Results Oral symptoms, even more profound ones such as toothache, were prevalent among all age groups. Overall, 58% of 12- and 45% of 15-year-olds reported at least one oral impact in the past three months. The most prevalent oral impact was feeling embarrassed to smile or laugh, followed by difficulty eating. These symptoms and oral impacts were disproportionately high among children eligible for free school meals. Furthermore, one fifth to one third of parents reported that their children's oral conditions had some impact on their family life.Conclusion Oral symptoms were common and oral conditions had a negative impact on the quality of life of large proportions of children. There were clear and marked socioeconomic inequalities, with considerably worse oral health perceptions and higher levels of oral impacts among the more deprived children.

Supporting people with dementia to eat.

The aim of this systematic review was to identify the best ways of supporting people with dementia to eat. Five electronic databases were searched, with a date range from January 2004 to July 2015. Following screening of the 233 studies identified, 22 were included in the final analysis. The study interventions focused on educational programmes, environmental or routine changes, and assistance with eating, with the strongest evidence shown in the more complex educational programmes for people with dementia. The evidence suggests that staff who support people with dementia to eat should undertake face-to-face education programmes and aim to give people enough time when helping them to eat. However, cultural change may be needed to ensure individual assessments are carried out to identify those having difficulty eating, and to ensure they are afforded enough time to eat their meals.

Laparoscopic Cecopexy for Mobile Cecum Syndrome as a Cause of Chronic Right Iliac Fossa Pain

Abstract Introduction: A 16-year-old girl underwent laparoscopy to investigate a 3-month history of intermittent right iliac fossa pain associated nausea, vomiting, difficulty eating, and a loss of 3 kg in weight. She reported an intermittent right-sided abdominal mass, not identified on ultrasonography. Methods: Standard port placement for a laparoscopic appendicectomy was used, with one secondary port placed suprapubically and the other in the left iliac fossa. The cecum was found to be very mobile and dilated. As demonstrated, the cecum could be freely rotated with the potential to cause intermittent cecal obstruction. Examination of the pelvis revealed unremarkable appearances of the fallopian tubes and ovaries. The appendix appeared macroscopically normal. A standard appendicectomy was performed with division of the mesoappendix using hook diathermy. The base of the appendix was ligated with 2 “0” vicryl endoloops. Cecopexy was then performed using three-point fixation. Three interrupted 2/0 Ethibond...

Considering the difficulties with dysphagia: an overview for community nurses.

The term dysphagia is used when a person has difficulty eating or swallowing. Around 11% of adults living in the community have dysphagia (Holland et al, 2011). It is associated with neurological problems, chronic obstructive airways disease (COPD), ageing and frailty (Turley and Cohen, 2009). Table 1 outlines the prevalence of dysphagia associated with common conditions. To swallow normally, a person requires an intact motor and nervous system (Royal College of Speech and Language Therapists (RCSLT), 2014). There are four phases in a normal swallow (Table 2).

Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) Physical Functioning Items.

Physical functioning is an important health domain for adults. Evaluate physical functioning items in Medicare beneficiaries. Survey data from the 2010 Consumer Assessment of Healthcare Providers and Systems Medicare survey. The 366,701 respondents were 58% female; 38% were 75 or older; 57% had high school education or less. Walking, getting in or out of chairs, bathing, dressing, toileting, and eating assessed with 3 response choices: unable to do, have difficulty, do not have difficulty. Pearson correlations among the 6 items ranged from 0.515 to 0.835 (coefficient α=0.92). A single factor categorical factor analytic model fit the data well (comparative fit index=0.998; root mean square error of approximation=0.083). The item with the highest percentage of respondents reporting no difficulty was eating, followed by toileting, dressing, bathing, getting in and out of a chair, and walking. Threshold parameters from an item response theory-graded response model ranged from -1.983 (between unable to do and have difficulty eating) to -0.551 (between have difficulty and no difficulty walking). Item discrimination parameters ranged from 4.632 (walking) to 8.228 (dressing). IRT-scored physical functioning scores correlated with self-rated general health (r=0.389, n=344,843, P<0.0001) mental health (r=0.296, n=351,254, P<0.0001) and number of chronic conditions (r=-0.229, n=284,507, P<0.0001). The physical functioning items target relatively easy activities, providing information for a minority of people in the sample with the lowest levels of physical functioning. Items representing higher levels of physical functioning are needed for the majority of the Medicare beneficiaries.

The pliancy of pedicled buccal fat pad used in reconstruction of oral submucous fibrosis-a case report

Oral submucous fibrosis (OSF) has multifactorial aetiology which is considered to include betel quid chewing, excessive use of chillies and spices, poor nutrition and deficiency of vitamin and iron. Various treatment modalities such as nutritional supplement, intralesional steroid and placental extract injections, antioxidants, and physiotherapy have been used for conservative management of OSF. Surgical treatment includes fibrotomy (release of fibrotic bands), coronoidectomy, third molar extractions and/or reconstruction of buccal mucosa with various autografts and allografts. A 30-year old male patient reported to the Out Patient Department of Oral and Maxillofacial Surgery with the chief complaint of inability to open the mouth and difficulty in eating. Based on peculiar clinical findings, provisional diagnosis of OSF was established. Under general anesthesia, horizontal mucosal incision was placed along the occlusal plane with the surgical knife on the buccal mucosa 1cm below Stenson's duct orifice bilaterally. The fibrous bands were palpated and using fingers dissection was carried out to release fibrous bands which were followed by bilateral coronoidectomy. Pedicled buccal fat pad (BFP) was used as a graft material to cover the areas on both sides. Healing was satisfactory with no breakdown or liquefaction necrosis post operatively. Approximately 30 mm of interincisal distance was achieved and maintained postoperatively with vigorous mouth opening exercises. BFP can be used effectively as a grafting material in the surgical management of OAF with good functional and esthetic outcome.

Psycho-social impact of orthogathic sugery.

BackgroundOrthognathic surgery is a branch of maxillofacial surgery. It carries out the treatment of the facial skeleton asymmetries and deformities. The patients who ask for this surgery are often young people who usually refer symptoms related to dental malocclusion, difficulty eating and temporo-mandibular pain. These physical symptoms are often accompanied by psychological symptoms triggered by their physical appearance such as low self-esteem, self-confidence and negativism about their social and emotional future.Material and MethodsPatients with skeletal malformation of facial bones, consisting in Class II, III, open bite and asymmetries, underwent to orthognathic surgery in our center agreed to participate voluntarily in this study. They answered a questionnaire regarding several psychosocial variables.ResultsOrthognathic surgery helps to improve patient’s psychosocial well-being.ConclusionsPatients with dentofacial deformitiesexperience physical and psychological, oftentimes underestimated by society. A combination of orthodontic treatment and reconstructive surgery is often a necessity to restore function and psychosocial well-being. Key words:Orthogathic surgery, psychosocial consequences, mood, emotions, sense of power, motivation, satisfaction, social changes, satisfaction.

Soda Consumption Among Methamphetamine Users in the USA: Impact on Oral Health.

Dental disease is associated with methamphetamine (MA) use and partly attributed to excessive consumption of sugared sodas. Hence, the purpose of this study was to verify patterns of sugared soda intake and their relationship to oral health. Detailed assessments with 541 MA users at two dental clinics were conducted. Assessment included a lifetime history of methamphetamine use, sugared soda consumption and a dental exam. Subjects were predominantly male (80.8%; mean age 44.4 years), on average had used MA for 11.6 years and drank an average of 35.3 sodas per month. Number of days of MA use over the past 30 days was significantly associated with soda consumption. Increased years of MA use was associated with the likelihood of users reporting less overall satisfaction with life because of their teeth, specifically difficulty eating, and dry mouth. This is the first study to show a statistically significant association between MA use and sugared soda consumption. MA users' consumption of sugared sodas is higher than in the adult general population, and this is the first study to show a statistically significant association between MA use and sugared soda consumption. In addition, increased soda consumption was associated with more dental problems among MA users.

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy.

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy.